Abstract
Ultrasound assessment plays an important role in the diagnosis, and monitoring of subacute thyroiditis (SAT). However, the relationship between ultrasonographic findings and severity or prognosis of the disease is not known. The aim of the present study was to evaluate the relationship between bilateral and unilateral disease involvement and severity and prognosis of the disease. The initial laboratory values, ultrasonographic findings and long-term outcomes of 247 SAT patients were evaluated retrospectively. In the ultrasonographic evaluation, bilateral involvement was detected in 154 patients, and unilateral involvement in 93 patients at the time of diagnosis. No significant difference was found between patients with bilateral or unilateral disease at the time of diagnosis in respect of the initial acute phase reactants. FT4 was significantly higher and TSH was significantly lower in the group with bilateral disease. Bilobar or unilobar disease on ultrasound at the time of diagnosis was not found to be a risk factor for permanent hypothyroidism or recurrence. The mean thyroid volume was determined to be 22.5 ± 10 cm3 at the beginning of treatment, and 11.2 ± 8 cm3 at the end of treatment. The initial thyroid volume and the thyroid volume at the end of treatment were significantly lower in patients who developed hypothyroidism. There was no relationship between initial acute phase reactants and bilateral or unilateral involvement of the disease. FT4 levels were found to be associated with the extension of the disease. The risk of recurrence and permanent hypothyroidism are not associated with the initial ultrasonographic aspect. Arch Endocrinol Metab. 2020;64(3):306-11.
Highlights
Subacute thyroiditis (SAT) is a self-limiting inflammatory thyroid disease with a history of viral etiology
FT4 was significantly higher in the group with bilateral disease (p: 0.014), and thyroid stimulating hormone (TSH) level was significantly lower in the group with bilateral disease (p: 0.018) (Table 2)
Data are presented as mean ± standard deviation (SD), median; ESR: erythrocyte sedimentation rate; CRP: C-reactive protein; TSH: thyroid stimulant hormone; fT4: free thyroxine; fT3: free triiodothyronine; Anti-TPO: anti thyroid peroxidase antibody; Anti-TG: anti thyroglobulin antibody
Summary
Subacute thyroiditis (SAT) is a self-limiting inflammatory thyroid disease with a history of viral etiology. There was no significant difference in terms of WBC, neutrophil count, ESR and CRP levels between patients with bilateral and unilateral disease at the time of diagnosis (p > 0.05). Detection of bilateral or unilateral disease involvement on ultrasound at the time of diagnosis was not found to be a risk factor for recurrence (p: 0.39).
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